Sciatica is a complex problem that many of us have either experienced, or know someone that has. “Sciatic pain” however, is not just one problem but an umbrella term used to describe many different problems that cause the sensation of nerve pain in the area of the body controlled by the sciatic nerve.
Nerve pain can be caused by any irritation of a nerve either through compression, excessive or prolonged stretching, damage due to trauma, local chemical changes or even interference from scar tissue.
Nerve pain can feel different to different people and can be in different areas for different people, with either hot or cold feelings, pins and needles or numbness, sharp or shooting pains or even loss of power to muscles. These differences are dependent on which nerve has been affected and how significantly it has been affected.
The reason why sciatic pain can be caused by so many different problems is because the path of the sciatic nerve can be affected by multiple structures.
The four structures that are mostly responsible for sciatic pain are:
When our nerves travel from the spinal cord and leave the spine, they must pass through small holes between vertebrae. These holes (foramen) can be narrowed by different variables such as repetitive poor movement patterns, degeneration of joints, dehydration of spinal discs or disc protrusion.
The lowest segment of the spine, the sacrum, also has small holes through which nerves emerge to service our legs. If the sacrum is not gliding correctly through movement or there is poor alignment of the pelvis, these nerves can be affected.
Within the buttock muscles, there is a singular muscle called the piriformis. In most of the population, the sciatic nerve passes underneath this muscle, but 17% of people have this nerve pass through the piriformis. Incorrect length or function of the piriformis muscle can aggravate the sciatic nerve in both populations but is more likely among the 17%.
The Muscles of the Leg
Scar tissue and a history of damage to muscles close to the sciatic nerve can cause adherence to the nerve itself and lead to pain.
Due to these multiple causes, there are multiple solutions to what seems as though it is the same problem. What may be beneficial for your relative or friend with sciatica, may not be as effective, or may even be detrimental to your own situation. This is why it is important to consult your physiotherapist, who will perform a thorough examination, to determine which problem is attributing to your nerve pain and create a program tailored specifically for you.